Vasopressin combined with epinephrine decreases cerebral perfusion compared with vasopressin alone during cardiopulmonary resuscitation in pigs.

BACKGROUND AND PURPOSE: It is unknown whether a combination of vasopressin and epinephrine may be superior to vasopressin alone by targeting both nonadrenergic and adrenergic receptors. METHODS: After 15 minutes of cardiac arrest (13 minutes of ventricular fibrillation and 2 minutes of pulseless electrical activity) and 3 minutes of chest compressions, 16 animals were randomly treated with either 0.8 U/kg vasopressin (n = 8) or 0.8 U/kg vasopressin combined with 200 microg/kg epinephrine (n = 8). RESULTS: Comparison of vasopressin with vasopressin and epinephrine at 90 seconds and 5 minutes after drug administration resulted in comparable mean (+/-SEM) coronary perfusion pressure (54+/-3 versus 57+/-5 and 36+/-4 versus 35+/-4 mm Hg, respectively), cerebral perfusion pressure (59+/-6 versus 65+/-8 and 40+/-6 versus 39+/-6 mm Hg, respectively), and median (25th to 75th percentiles) left ventricular myocardial blood flow [116 (81 to 143) versus 108 (97 to 125) and 44 (35 to 81) versus 62 (42 to 74) mL x min(-1) x 100 g(-1), respectively], but significantly increased (P<0.05) total cerebral blood flow [81 (77 to 95) versus 39 (34 to 58) and 50 (43 to 52) versus 28 (16 to 35) mL x min(-1) x 100 g(-1), respectively]. Return of spontaneous circulation rates in both groups were comparable (vasopressin, 7 of 8; vasopressin and epinephrine, 6 of 8). CONCLUSIONS: Comparison of vasopressin with vasopressin and epinephrine resulted in comparable left ventricular myocardial blood flow but significantly increased cerebral perfusion.

Terminal deoxynucleotidyl transferase (TdT) and membrane receptors in human leukemia and lymphoma -- first experience with lyophilized cells.

Surface marker analyses and TdT assays were performed on cells from 31 patients. A variety of diagnoses were made and categorized as follows: acute leukemia (group I), non-Hodgkin lymphoma (group II) and diverse diagnoses (group III). Levels of TdT in the range from 0 to 7.9 U/mg lyophilized blasts from the peripheral blood were found in AL. This corresponds to 0-95 U/10(8) cells. Preparations of mononuclear cells from the peripheral blood of healthy donors showed TdT values up to 0.88 U/mg or 10.6 U/10(8) cells. High TdT activity was observed in a patient with AML, type M1 according to the FAB classification. In a patient with ALL (L1) cytostatic treatment effected the clearance of TdT activity from the peripheral blood cells and at the same time induced a significant increase of E rosette forming cells. Combined studies of the TdT activity and cell surface markers may enable us to define remissions and relapses of AL more precisely than it is possible by conventional cytological methods. Within the group II two patients with moderate TdT activities of 1.2 and 1.28 U/mg, respectively, were observed whose cells were of prolymphocytic or unclassifiable appearance, respectively. The TdT assay may be helpful to identify such cells of unknown origin and in addition may provide the means of discrimination between such cases and ALL patients who mostly show high TdT activities. Another result of our studies was the finding of moderate TdT activity of 1.2 U/mg with cells from the pleural effusion of a patient with Hodgkin's disease. Cells from malignant effusions from a patient with melanoma and a patient with teratoid carcinoma showed no TdT activity. Cells form the peripheral blood and from the bone marrow of a patient with blast crisis of CML showed TdT activity of 1.52 and 2.72 U/mg, respectively. Two other patients with blast crisis were negative. Not TdT activity was found in leukemic plasma cells. Our results show that lyophilized cells can be used for determinations of TdT activity. This greatly facilitates multi-parameter studies including cytological, cell surface marker and biochemical analyses.

[Heavy chain disease: humoral and cellular findings in six patients with mu chain disease (author's transl)]. / H-Kettenkrankheit: Humorale und celluläre Befunde bei sechs Fällen vom mu-Kettentyp.

Clinical and chemical findings in 6 patients with mu-chain disease are reported. In all of these patients a lymphoproliferative disease was observed which by its symptoms resembled CLL. This similarity was underlined by the finding of an impaired response of PBL of the patients to mitogens as PHA, PWM, and Con A. A substantial result of our studies lies in the fact that the presence of mu-chains in the serum does not correlate with a clinically defined entity. Moreover, mu-chains have been observed in a case of benign lymphadenopathy. In one case a good remission of 4 years duration could be induced by the application of cytostatic agents.

Surface markers on peripheral blood lymphocytes of patients with follicular lymphoma suggesting a clonal origin.

PBL of 14 patients with FL were examined by membrane fluorescence using anti-Ig antibodies (mu, gamma, delta; kappa, lambda), spontaneous rosette formation with SRBC and rosette formation with SRBC coated by antibody-complement complexes (EAC). Eight of the patients were untreated. In 3 patients monoclonal Ig were detected in the serum or urine. 7 patients exhibited clonal proliferation as judged by analysis of surface Ig. In addition, normal or elevated figures for EAC rosettes were found. The strong expression of S. Ig in PBL of FL patients is in contrast to the findings in CLL and multiple meloma, the increase of EAC-rosettes is shared by myeloma patients. It follows that membrane properties of PBL as studied in this work is of value in the diagnosis of malignancies of the B-cell system.

[Clinical features of malignant follicular non-Hodgkin's lymphoma (author's transl)]. / Zur Klinik der malignen follikulären Non-Hodgkin-Lymphome.

75 cases treated between 1970 and 1976 for malignant follicular non-Hodgkin's lymphoma were analysed for their cardinal signs. Contrary to non-Hodgkin's lymphoma of "higher malignancy degree", the average age of patients with malignant follicular non-Hodgkin's lymphoma is generally over 50 years, being more common in females. By the time the diagnosis is made a generalised stage has usually been reached. In the described group of patients the five-year survival rate was 65%, but compared with the malignant lymphoma of higher malignancy the prognosis is often complicated by secondary diseases resulting from the higher age. The findings confirm the need for histological sub-classification of malignant non-Hodgkin's lymphoma.